TB down in past decade; universal health coverage key

MANILA, 23
MARCH 2018 – New estimates show a 14% reduction
in the incidence of tuberculosis (TB) in the World Health
Organization (WHO) Western Pacific Region over the past
decade, but with 1.8 million people newly infected in the
Region each year, more needs to be done. On the eve of World
Tuberculosis Day, WHO calls on governments to provide all
citizens access to TB testing and treatment as part of
universal health coverage.

“The TB rate is coming
down in the Region, but it’s not happening fast enough. We
need to do much more to achieve our goal of ending the
epidemic once and for all,” says Dr Shin Young-soo, WHO
Regional Director for the Western Pacific.

The
Region has seen progress, with TB treatment coverage
increasing to 76% in 2016 from 69% in 2007. The TB mortality
rate in the Region (5 per 100 000 population in 2016)
remains much lower than the global average (17 per 100 000).
More than 90% of new cases in the Region have been treated
successfully, but drug-resistant forms of the disease remain
a concern.

WHO’s End TB Strategy calls on
countries to reduce TB deaths by 95% and cut new cases by
90% between 2015 and 2035. To reach the strategy’s 2020
interim target, the speed of reducing TB incidence in the
Western Pacific Region must accelerate to 4–5% per year
from the current 2%.

One in four people with TB are
not getting treatment through public health programmes.
Action is needed to understand whether they are getting
effective treatment in the private system or not at all.

What is TB?

TB is one of the
top 10 causes of death in the world. When someone with lung
TB coughs, sneezes, or spits, they can spread the infection.
TB germs can remain in the air for up to six hours, making
people in overcrowded areas especially susceptible.

Symptoms include persistent cough, bloody sputum, fever,
chills and weight loss. The disease can be especially
devastating for people with other health issues, such as HIV
and diabetes, that weaken their immune system. The risk of
TB also increases for people who are undernourished, smoke
tobacco, drink alcohol or are exposed to air pollution.

Initially some people may experience only mild symptoms
and not realize they are infected. Others may not have
access to treatment, either because of service availability
or cost. A person with untreated TB can infect up to 15
others a year.

“While TB is highly contagious, it
is also entirely preventable and curable,” says Dr Shin.
“That is what makes its impact so tragic.”

A disease of poverty

More
tragic is the fact that TB often strikes those who can least
afford it. More than 95% of TB cases and deaths in the world
are in developing countries, with 45% of new cases in Asia,
according to 2016 figures.

In parts of the Western
Pacific Region, up to 60% of TB patients and their families
face catastrophic costs—that is, more than 25% of
household income goes on treatment. The financial burden
includes not only costs such as hospitalization and
medicine, but also non-medical costs such as transportation
and lodging and loss of income while receiving care. By
2020, no family should face catastrophic costs due to TB,
according to the End TB Strategy targets.

WHO calls
on governments to accelerate progress towards universal
health coverage so that all people have access to good
quality health services, where and when they need them,
without financial hardship. Reducing costs and other
barriers makes those infected with TB more likely to seek
treatment early. As a result, they will recover faster,
diminishing the chances of spreading the disease, and be
able to resume healthy, productive lives.

“Universal health coverage can contribute to a
substantial reduction in TB rates, while helping families
avoid spiralling into poverty. Governments are beginning to
realize that investing in universal health coverage actually
saves money in the long run,” explains Dr Shin.

In
addition to improving coverage of existing services,
including faster scale-up of new technologies, putting an
end to TB in the Region requires innovations in diagnostics,
treatments, vaccines and service delivery.

WHO is
calling on countries to address all the determinants of TB
through high-level commitments and approaches that involve
sectors outside of health, such as education and
housing.

Dr Shin stresses that countries must stay
the course: “By taking these steps, we inch ever closer to
achieving our vision of zero deaths, zero disease and zero
suffering due to TB.”

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